MICHELE LUGLIO
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
16 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 16
- Fluid Overload: A Question in Pediatric Intensive Care Spotlight?(2016) LUGLIO, Michele; DELGADO, Artur Figueiredo; CARVALHO, Werther Brunow de
- Stress Ulcer Prophylaxis Remains a Controversial Management in the PICU(2020) RAMOS, Gabriel F.; LUGLIO, Michele; CARVALHO, Werther Brunow de; DELGADO, Artur Figueiredo
- Acute petrified myocardium associated with meningococcal sepsis in childhood-onset systemic lupus erythematous: a fatal case(2019) SANTOS, Ana Carolina Etrusco Zaroni; LUGLIO, Michele; DELGADO, Artur Figueiredo; SCHUWARTZ, Constance Dell Santo Vieira; MARQUES, Heloisa Helena Sousa; VALOES, Clarissa Carvalho de Miranda; DOMINGUEZ, Maria Andreina Cabrera; CARVALHO, Werther Brunow de; SILVA, Clovis Artur; DUARTE-NETO, Amaro NunesAcute petrified myocardium associated with septic shock, diagnosed by autopsy has rarely been described. A 15-year-old adolescent male was diagnosed with childhood-onset systemic lupus erythematosus. One year later, he was hospitalized with fever, myalgia, headache, arthritis, vomiting, dyspnea and was diagnosed with sepsis secondary to bronchopneumonia and meningitis. Blood culture identified Neisseria meningitidis serogroup Y. Despite antibiotics and intensive therapeutic measures, he died after 29 days of hospitalization. The autopsy revealed necrotic cardiomyocytes with dystrophic calcification and interstitial fibrosis.
- The Latin American and Spanish Survey on Nutrition in Pediatric Intensive Care (ELAN-CIP2)(2019) CAMPOS-MINO, Santiago; CID, Jesus Lopez-Herce; DELGADO, Artur Figueiredo; BENAVIDES, Eliana Munoz; COSS-BU, Jorge A.; VILLAVICENCIO, Pedro Mestre; IRAMAIN, Ricardo; VILLARUEL, Sayani Valdez; NIEVA, Ana; VARGAS, Ana; LOPEZ, Pilar Arias; FERNANDEZ, Analia; SILVESTRE, Andrea; BOTTA, Priscila; TORRES, Silvio Fabio; COSTA, Caroline Abud Drumond; GARCIA, Pedro Celiny Ramos; PIVA, Jefferson; CABEDO, Maria Thereza De Cordes; LUGLIO, Michele; ZAMBERLAN, Patricia; GUZMAN, Gustavo; LOBOGUERRERO, Fanny Garcia; FERNANDEZ, Mauricio; CASSALETT, Gabriel; PEREZ, German; MONTES, Miguel Ruz; VELASQUEZ, Rocio Porras; PEREZ, Victor; CASTRO, Santiago Ramirez; VILLAVICENCIO, Pedro Mestre; WEGNER, Adriana; ORDENES, Nadia; DESSAUER, Bettina Von; CORS, Carolina; GONZALES, Marcos; BENAVIDES, Eliana Munoz; QUIROZ, Miguel Angel Saavedra; PERALTA, Felipe Verscheure; ROQUE, Jorge; ROSICH, Patricia Del Rosario; CAMPOS-MINO, Santiago; MONTALVO, Erika; PESANTES, Xavier Paez; BARQUIN, Luis Augusto Moya; RIVAS, Ricardo Alfredo Mack; ROMAN, Carlos; ORTIZ, Cesar Antonio Ramos; MONSREAL, Miguel Ignacio Flores; VILLARUEL, Sayani Valdez; GONZALEZ, Sonia Vargas; JIMENEZ, Hassel Jimmy; BRACHO, Carlos; SAMUDIO, Lissa; PALPAN, Beatriz Atachagua; PALOMO, Patricia; ESCALANTE-KANASHIRO, Raffo; ARANA, Rosa; NUNEZ, Antonio Rodriguez; CID, Jesus Lopez-Herce; FERNANDEZ, Yolanda Lopez; MENCHACA, Amanda; LOPEZ, Claudia MadridObjective: To characterize the practices of nutritional support in Latin American and Spanish PICUs. Design: Survey with a questionnaire sent to Latin American Society of Pediatric Intensive Care members. Setting: PICUs of participant hospitals. Patients: Critically ill children between 1 month and 18 years old. Interventions: None. Measurements and Main Results: Forty-seven surveys from 17 countries were analyzed. Sixty-seven percent of PICUs were from university-affiliated hospitals, with a median of 380 admissions/yr. Sixty-eight percent and 48.9% had a nutritional support team and nutritional support protocol, respectively. Seventy-five percent completed nutritional evaluations, with 34.2% at admission. PICUs with high-volume admissions were likely to have a nutritional support team (p < 0.005), and university-affiliated hospitals showed a trend of having a nutritional support team (p = 0.056). Measured, estimated, and ideal weights were used in 75%, 14.6%, and 10.4%, respectively. Energy requirements were calculated using Holliday & Segar and Schofield equations in 90% of the PICUs; 43% used correction factors. Only three PICUs had indirect calorimetry. At day 3 of initiation of nutritional support, 57.3% of PICUs provided at least 50% of the calculated energy requirement, and 91.5% at day 5. Protein needs were estimated according to American Society for Parenteral and Enteral Nutrition and European Society for Clinical Nutrition and Metabolism/European Society for Paediatric Gastroenterology Hepatology and Nutrition guidelines in 55.3% and 40.4%, respectively. Enteral nutrition was the preferred feeding method, initiated in 97.7% at 48 hours. The feeding route was gastric (82.9%), by bolus (42.5%) or continuous (57.4%). Monitoring methods included gastric residual measurement in 55.3%. Enteral nutrition was discontinued in 82.8% when gastric residual was 50% of the volume. Prokinetics were used in 68%. More than half of PICUs used parenteral nutrition, with 95.8% of them within 72 hours. Parenteral nutrition was administered by central vein in 93.6%. Undernourished children received parenteral nutrition sooner, whether or not enteral nutrition intolerance was present. When enteral nutrition was not tolerated beyond 72 hours, parenteral nutrition was started in 57.4%. Parenteral nutrition was initiated when enteral nutrition delivered less than 50% in 97%. Conclusions: Nutritional practices are heterogeneous in Latin American PICUs, but the majority use nutritional support strategies consistent with international guidelines.
- Effects of serum sodium and chloride levels in the outcome of critically ill pediatric patients in the post-operative period of liver transplantation(2023) LUGLIO, Michele; CARVALHO, Werther B. de; TANNURI, Uenis; TANNURI, Ana Cristina A.; MATSURA, Rodrigo Hideki; FRANCA, Gardenia Morais; DELGADO, Artur F.BackgroundSodium and chloride disturbances have attracted increasing attention in recent years. Many pathophysiological effects are associated with hyperchloremia, including reduction in mean arterial pressure and acute renal disease. Pediatric patients undergoing liver transplantation are at risk of developing various electrolyte and biochemical abnormalities, with an impact on their postoperative outcomes.ObjectiveTo analyze the impacts of serum sodium and chloride levels on prognosis of Pediatric Liver Transplant receptors.MethodsThis was a retrospective analytical observational study performed in a single transplant reference center in Sao Paulo, Brazil. Included patients were pediatric patients who underwent liver transplantation between January 2015 and July 2019. Statistical regression analysis and General Estimating Equations analysis were performed to evaluate the impacts of sodium and chloride disturbances on the development of acute renal failure and mortality.ResultsA total of 143 patients were included in this study. The main diagnosis was Biliary Atresia (62.9%). Twenty-seven patients died (18.9%), and graft dysfunction was the main cause of death (29.6%). The only variable individually associated with 28-days mortality was PIM-3 score (HR 1.59, CI 95% 1.165-2.177, p = 0.004). Forty-one patients (28.6%) developed moderate or severe AKI. PIM-3 score (OR 3.052, 95% CI 1.56-5.97, p = 0.001), hypernatremia (OR 3.49, 95% CI 1.32-9.23, p = 0.012), and hyponatremia (OR 4.24, 95% CI 1.52-11.85, p = 0.006) were independently associated with the development of moderate/severe AKI.ConclusionsIn pediatric patients after liver transplantation, PIM-3 score, and abnormal serum sodium levels were correlated with AKI development.
bookPart Manifestações gastrointestinais e do sistema nervoso na COVID-19(2021) TOMA, Ricardo Katsuya; PAZ, José Albino da; LUGLIO, MichelebookPart Avaliação laboratorial da criança e do adolescente dependente de cuidados domiciliares(2023) LUGLIO, Michele; RODRIGUEZ, Isadora Souza- Fluid Accumulation and Pediatric Acute Respiratory Distress Syndrome: What Do We Really Know?(2019) LUGLIO, Michele; DELGADO, Artur Figueiredo; CARVALHO, Werther Brunow de
- COVID-19 and Liver Damage: Narrative Review and Proposed Clinical Protocol for Critically ill Pediatric Patients(2020) LUGLIO, Michele; TANNURI, Uenis; CARVALHO, Werther Brunow de; BASTOS, Karina Lucio de Medeiros; RODRIGUEZ, Isadora Souza; JOHNSTON, Cintia; DELGADO, Artur FigueiredoSARS-CoV-2 shares nearly 80% of its' genomic sequence with SARS-CoV and MERS-CoV, both viruses known to cause respiratory symptoms and liver impairment. The emergence of pediatric cases of multisystem inflammatory syndrome related to the SARS-CoV-2 infection (PIM-TS) has raised concerns over the issue of hepatic damage and liver enzyme elevation in the critically ill pediatric population with COVID-19. Some retrospective cohorts and case series have shown various degrees of ALT/AST elevation in SARS-CoV-2 infections. A limited number of liver histopathological studies are available that show focal hepatic periportal necrosis. This liver damage was associated with higher levels of inflammatory markers, C-reactive protein (CRP), and pro-calcitonin. Proposed pathophysiological mechanisms include an uncontrolled exacerbated inflammatory response, drug-induced liver injury, direct viral infection and damage to cholangiocytes, hypoxic-ischemic lesions, and micro-thrombosis in the liver. Based on the physiopathological characteristics described, our group proposes a clinical protocol for the surveillance, evaluation, management, and follow-up of critically ill pediatric COVID-19 patients with liver damage.
- Noninvasive Ventilation: More Useful Than It Seems?(2015) LUGLIO, Michele; PANCERA, Christiane; CARVALHO, Werther Brunow de